<%@ include file="/view/template/header.jsp"%>	
	<div id="content">
    	<%@ include file="/view/ehr/ehr_common.jsp"%>
        <div class="right-content">
			<div class="box">
				<s:if test='replyMessage.message!="empty"'>
					<h3><s:property value="replyMessage.message"/></h3>
				</s:if>
					<h1><s:text name="label.medicalRecords.patient_information" /></h1>
					<s:form action="add_health_records_form">
						<div class="con-part">
							<span><s:label key="label.medicalRecords.patient_Id" required="true" ></s:label><img name="logo" src="<% out.print(baseURL);%>/view/required.jpg" width="15" height="20" alt="required" /></span>
							<s:if test="#parameters['patient_id'][0]!=0">
								<s:textfield key="medicalRecords.patientId" value="%{#parameters['patient_id'][0]}" readonly="true" required="true" cssErrorClass="error"/>
							</s:if>
							<s:else>
								<s:textfield key="medicalRecords.patientId" value="%{medicalRecords.patientId}" readonly="true" required="true" cssErrorClass="error"/>
							</s:else>
							<s:fielderror cssStyle="errorMessage"><s:param value="%{'medicalRecords.patientId'}"/></s:fielderror>
						</div>
						<div class="clear"></div>
						<h1><s:text name="label.medicalRecords.observation_information" /></h1>
						<div class="clear"></div>
						<div class="con-part">
							<span><s:label key="label.medicalRecords.observation"></s:label></span>
							<s:textarea key="medicalRecords.observation" cssErrorClass="error" cssClass="textareaStyle"/>
							<s:fielderror cssStyle="errorMessage"><s:param value="%{'medicalRecords.observation'}"/></s:fielderror>
						</div>
						<div class="con-part">
							<span><s:label key="label.medicalRecords.observerId"></s:label></span>
							<s:textfield key="medicalRecords.observerId" cssErrorClass="error"/>
							<s:fielderror cssStyle="errorMessage"><s:param value="%{'medicalRecords.observerId'}"/></s:fielderror>
						</div>
						<div class="con-part">
							<span><s:label key="label.medicalRecords.observationdate"></s:label></span>
							<s:textfield name="medicalRecords.observationdate" id="datetimepicker" class="input-text" cssErrorClass="error"></s:textfield>
							<s:fielderror cssStyle="errorMessage"><s:param value="%{'medicalRecords.observationdate'}"/></s:fielderror>
						</div>
						<div class="clear"></div>
						<h1><s:text name="label.medicalRecords.diagosis_information" /></h1>
						<div class="con-part">
							<span><s:label key="label.medicalRecords.diagosis"></s:label></span>
							<s:textarea key="medicalRecords.diagosis" cssErrorClass="error" cssClass="textareaStyle"/>
							<s:fielderror cssStyle="errorMessage"><s:param value="%{'medicalRecords.diagosis'}"/></s:fielderror>
						</div>
						<div class="con-part">
							<span><s:label key="label.medicalRecords.diagnosingClinicianId"></s:label></span>
							<s:textfield key="medicalRecords.diagnosingClinicianId" cssErrorClass="error"/>
							<s:fielderror cssStyle="errorMessage"><s:param value="%{'medicalRecords.diagnosingClinicianId'}"/></s:fielderror>
						</div>
						<div class="con-part">
							<span><s:label key="label.medicalRecords.diagnosingDate"></s:label></span>
							<s:textfield name="medicalRecords.diagnosingDate" id="datetimepicker1" class="input-text" cssErrorClass="error"></s:textfield>
							<s:fielderror cssStyle="errorMessage"><s:param value="%{'medicalRecords.diagnosingDate'}"/></s:fielderror>
						</div>
						<div class="button_bar2">
							<s:submit key="label.medicalRecords.submit" align="center" cssClass="green"/>
						</div>
					</s:form>
			</div>
		</div>
	</div>
	<script type="text/javascript" src="<% out.print(baseURL);%>/view/template/js/jquery-ui-timepicker-addon.js"></script>
	<script>
$(function() {
$("#tabs").tabs();
});
$(function() {
$('#datetimepicker').datetimepicker();
});
$(function() {
	$('#datetimepicker1').datetimepicker();
	});
</script>
<%@ include file="/view/template/footer.jsp"%>